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Blazquez A, Falcó N, Caño E, Rodriguez F, Vassena R, Miguel-Escalada I, Popovic M, Rodriguez A. No association between LH levels and ovarian response in oocyte donors triggered with gonadotropin-releasing hormone agonist: A prospective study. Eur J Obstet Gynecol Reprod Biol 2024; 294:163-169. [PMID: 38266482 DOI: 10.1016/j.ejogrb.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/14/2023] [Accepted: 01/15/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE Are circulating luteinizing hormone (LH) levels predictive of ovarian response in oocyte donors triggered with gonadotropin-releasing hormone (GnRH) agonists? STUDY DESIGN A prospective cohort study with 224 oocyte donation cycles between 2021 and 2022 at a single center, examined the relationship between circulating luteinizing hormone (LH) levels and ovarian response. Oocyte donors underwent GnRH antagonist downregulation followed by GnRH agonist trigger. LH, estradiol, and progesterone levels were measured on day one of stimulation, trigger-day and 12 h post-trigger. Oocyte retrieval and maturity rates were analyzed using univariate and multivariate analyses, and the correlation between post-trigger LH levels and outcomes was assessed by Pearson's correlation test. A significance level of p < 0.05 was used. RESULTS Mean age was 26 ± 4.3 years, mean body mass index (BMI, kg/m2) was 22.6 ± 3.2 and mean antral follicle count (AFC) was 21.7 ± 8.2. Post-trigger LH levels averaged 51.3 IU/L (SD 34.8), and oocyte retrieval rate and maturity rates were 112,7% (+/-48,1%) and 77,8% (+/- 17,2%), respectively. No significant differences were found in these outcomes for donors with post-trigger LH values below and above 15 IU/L (Mann Whitney's p > 0.05). However, exploratory analyses revealed that post-trigger LH values < 22 IU/L and basal LH levels < 4 IU/L were associated with significantly lower oocyte retrieval rate (90 % vs 110 %, p = 0.019 and 100 % vs 110 %, p = 0.019, respectively). CONCLUSIONS This study, a first in exclusively focusing on oocyte donors, did not support the previously reported LH value of 15 IU/L as predictive of suboptimal ovarian response. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Identifier: NCT05109403.
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Affiliation(s)
| | - Noelia Falcó
- Clínica EUGIN - Eugin Group, Barcelona 08006, Spain
| | - Elena Caño
- Clínica EUGIN - Eugin Group, Barcelona 08006, Spain
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Sun L, Tong K, Liu W, Tian Y, Liu D, Huang G, Li J. Novel variants in ZP1, ZP2 and ZP3 associated with empty follicle syndrome and abnormal zona pellucida. Reprod Biomed Online 2023:S1472-6483(23)00045-7. [PMID: 36931917 DOI: 10.1016/j.rbmo.2023.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/31/2022] [Accepted: 01/08/2023] [Indexed: 01/18/2023]
Abstract
RESEARCH QUESTION Which genetic variants might explain the causes of empty follicle syndrome (EFS) and abnormal zona pellucida (ZP) and affect the success of treatment with assisted reproductive technologies (ART)? DESIGN Whole-exome sequencing was performed in probands with EFS and abnormal ZP. Sanger sequencing was used for variant validation. Using HEK-293T cells, the effects of ZP1 and ZP2 variants on protein expression were explored by western blotting, and the effect of the ZP1 variant on protein location was investigated via immunofluorescence. The protein structure was also analysed to investigate the pathogenicity of variants. RESULTS A homozygous nonsense variant in ZP1 (c.874C>T, p.Gln292*) was detected in a patient with EFS. A novel homozygous frameshift variant in ZP2 (c.836_837delAG, p.Glu279Valfs*6) and a novel heterozygous missense variant in ZP3 (c.1159G>A, p.Val387Met) were identified in two patients with ZP morphological abnormalities, respectively. Western blotting and immunofluorescence analysis showed that the ZP1 variant results in a premature stop codon, leading to the truncated ZP1 protein. The ZP2 variant, which is situated in the N-terminus, triggers the degradation of a premature termination protein. Additionally, the patient with the ZP3 variant achieved clinical pregnancy following intracytoplasmic sperm injection treatment. CONCLUSIONS These findings expand the mutational spectrum of ZP1, ZP2 and ZP3, and provide new evidence for genetic diagnosis of female infertility. The targeted genetic diagnosis of ZP genes is recommended to choose appropriate fertilization methods and improve success rates of treatment with ART.
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Pujalte M, Camo M, Celton N, Attencourt C, Lefranc E, Jedraszak G, Scheffler F. A ZP1 gene mutation in a patient with empty follicle syndrome: A case report and literature review. Eur J Obstet Gynecol Reprod Biol 2023; 280:193-197. [PMID: 36529558 DOI: 10.1016/j.ejogrb.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/22/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
Genuine empty follicle syndrome (gEFS) is a rare cause of female infertility; it is defined as the presence of cumulus-oocyte complexes (COCs) in follicular fluid but the absence of oocytes after denudation in an in vitro fertilization (IVF) programme. Mutations in one of the four genes encoding zona pellucida (ZP) proteins have been implicated in gEFS. The objectives of the present study were to explore the molecular basis of idiopathic infertility in a 35-year-old woman with gEFS (observed after four ovarian retrievals), compare her phenotype and genotype with those of other patients described in the literature, and discuss therapeutic approaches that could be adopted by reproductive health centres in this situation. Sequencing of the ZP genes revealed a new homozygous missense variant in ZP1: c.1097G > A;p.(Arg366Gln). The variant is located in the ZP-N domain, which is essential for ZP protein polymerization. An immunohistochemical assessment of an ovarian biopsy confirmed the absence of ZP1 protein. The novel variant appears to prevent ZP assembly, which would explain the absence of normal oocytes after denudation in our patient (and despite the retrieval of COCs). ZP gene sequencing should be considered for patients with a phenotype suggestive of gEFS. An etiological genetic diagnosis enables appropriate genetic counselling and a switch to an IVF programme (with a suitable denudation technique) or an oocyte donation programme.
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Affiliation(s)
- Mathilde Pujalte
- Department of Constitutional Genetics, Amiens University Hospital, Amiens, France
| | - Maïté Camo
- Reproductive Medicine and Biology Department, CECOS of Picardy, Amiens University Hospital, Amiens, France
| | - Noémie Celton
- Department of Constitutional Genetics, Amiens University Hospital, Amiens, France
| | - Christophe Attencourt
- Department of Anatomy and Pathological Cytology, Amiens University Hospital, Amiens, France
| | - Elodie Lefranc
- Reproductive Medicine and Biology Department, CECOS of Picardy, Amiens University Hospital, Amiens, France
| | - Guillaume Jedraszak
- Department of Constitutional Genetics, Amiens University Hospital, Amiens, France; EMATIM UR4666, CURS, Jules Verne University of Picardy, Amiens, France
| | - Florence Scheffler
- Reproductive Medicine and Biology Department, CECOS of Picardy, Amiens University Hospital, Amiens, France; Peritox UMR_I 01, CURS, Jules Verne University of Picardy, Amiens, France.
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Zhou J, Wang M, Yang Q, Li D, Li Z, Hu J, Jin L, Zhu L. Can successful pregnancy be achieved and predicted from patients with identified ZP mutations? A literature review. Reprod Biol Endocrinol 2022; 20:166. [PMID: 36476320 PMCID: PMC9730648 DOI: 10.1186/s12958-022-01046-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In mammals, normal fertilization depends on the structural and functional integrity of the zona pellucida (ZP), which is an extracellular matrix surrounding oocytes. Mutations in ZP may affect oogenesis, fertilization and early embryonic development, which may cause female infertility. METHODS A PubMed literature search using the keywords 'zona pellucida', 'mutation' and 'variant' limited to humans was performed, with the last research on June 30, 2022. The mutation types, clinical phenotypes and pregnancy outcomes were summarized and analyzed. The naive Bayes classifier was used to predict clinical pregnancy outcomes for patients with ZP mutations. RESULTS A total of 29 publications were included in the final analysis. Sixty-nine mutations of the ZP genes were reported in 87 patients with different clinical phenotypes, including empty follicle syndrome (EFS), ZP-free oocytes (ZFO), ZP-thin oocytes (ZTO), degenerated and immature oocytes. The phenotypes of patients were influenced by the types and location of the mutations. The most common effects of ZP mutations are protein truncation and dysfunction. Three patients with ZP1 mutations, two with ZP2 mutations, and three with ZP4 mutations had successful pregnancies through Intracytoplasmic sperm injection (ICSI) from ZFO or ZTO. A prediction model of pregnancy outcome in patients with ZP mutation was constructed to assess the chance of pregnancy with the area under the curve (AUC) of 0.898. The normalized confusion matrix showed the true positive rate was 1.00 and the true negative rate was 0.38. CONCLUSION Phenotypes in patients with ZP mutations might be associated with mutation sites or the degree of protein dysfunction. Successful pregnancy outcomes could be achieved in some patients with identified ZP mutations. Clinical pregnancy prediction model based on ZP mutations and clinical characteristics will be helpful to precisely evaluate pregnancy chance and provide references and guidance for the clinical treatment of relevant patients.
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Affiliation(s)
- Juepu Zhou
- grid.33199.310000 0004 0368 7223Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Road, Wuhan, 430030 China
| | - Meng Wang
- grid.33199.310000 0004 0368 7223Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Road, Wuhan, 430030 China
| | - Qiyu Yang
- grid.33199.310000 0004 0368 7223Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Road, Wuhan, 430030 China
| | - Dan Li
- grid.33199.310000 0004 0368 7223Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Road, Wuhan, 430030 China
| | - Zhou Li
- grid.33199.310000 0004 0368 7223Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Road, Wuhan, 430030 China
| | - Juan Hu
- grid.33199.310000 0004 0368 7223Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Road, Wuhan, 430030 China
| | - Lei Jin
- grid.33199.310000 0004 0368 7223Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Road, Wuhan, 430030 China
| | - Lixia Zhu
- grid.33199.310000 0004 0368 7223Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Road, Wuhan, 430030 China
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Zou T, Xi Q, Liu Z, Li Z, Hou M, Zhu L, Jin L, Zhang X. A Novel Homozygous Nonsense Mutation in ZP1 Causes Female Infertility due to Empty Follicle Syndrome. Reprod Sci 2022; 29:3516-3520. [PMID: 35773450 DOI: 10.1007/s43032-022-01024-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/20/2022] [Indexed: 12/14/2022]
Abstract
ZP1 is a critical glycoprotein in the formation of the zona pellucida. It plays an indispensable role in the maturation of oocytes. To identify the causative gene of empty follicle syndrome (EFS) in a patient from a consanguineous family, whole-exome sequencing was performed in the proband. We identified a novel homozygous nonsense mutation c.1260C > G (p. Tyr420X) in the ZP1 gene from two primary infertile patients. Western blot showed that Y420X mutation in ZP1 gene produced a truncated protein. However, the mutation had no significant effect on subcellular localization of the mutant protein. Our findings confirmed the important role of the ZP1 gene in human female reproduction, enriched the mutation spectrums of ZP1 gene, and expanded its applications in the clinical and molecular diagnoses of EFS.
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Affiliation(s)
- Tingting Zou
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology and Center for Human Genome Research, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China
| | - Qingsong Xi
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China
| | - Zhenxing Liu
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology and Center for Human Genome Research, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China
| | - Zhou Li
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China
| | - Meiqi Hou
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology and Center for Human Genome Research, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China
| | - Lixia Zhu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China.
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China
| | - Xianqin Zhang
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology and Center for Human Genome Research, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China.
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Wang J, Yang X, Sun X, Ma L, Yin Y, He G, Zhang Y, Zhou J, Cai L, Liu J, Ma X. A novel homozygous nonsense mutation in zona pellucida 1 (ZP1) causes human female empty follicle syndrome. J Assist Reprod Genet 2021; 38:1459-1468. [PMID: 33665726 DOI: 10.1007/s10815-021-02136-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/25/2021] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To identify a pathogenic gene mutation in a female infertility proband characterized by empty follicle syndrome (EFS) and explore the genetic cause of EFS. METHODS Whole exome sequencing (WES) was performed to identify the candidate pathogenic mutation. Sanger sequencing was used to validate the mutation in family members. The pathogenicity of the identified variant and its possible effects on the protein were evaluated with in silico tools. Immunofluorescence staining was used to study the possible mechanism of the mutation on affected oocyte. RESULTS We identified a family with a novel homozygous nonsense mutation in zona pellucida 1 (ZP1) (c.199G > T [p.Glu67Ter]). Based on bioinformatics analysis, the mutation was predicted to be pathogenic. This variant generates a premature stop codon in exon 2 at the 199th nucleotide, and was inferred to result in a truncated ZP1 protein of 67 amino acids at the ZP-N1 domain. An in vitro study showed that the oocyte of the EFS proband was degenerated and the zona pellucida was absent. Additionally, the mutant ZP1 proteins were localized in the cytoplasm of the degenerated oocyte but not at the surface. CONCLUSIONS The novel mutation in ZP1 is a genetic cause of female infertility characterized by EFS. Our finding expands the genetic spectrum for EFS and will help justify the EFS diagnosis in patients.
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Affiliation(s)
- Jing Wang
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xiaoyu Yang
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xueping Sun
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Long Ma
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yaoxue Yin
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Guoxiang He
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yuan Zhang
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Jie Zhou
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Lingbo Cai
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Jiayin Liu
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xiang Ma
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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Yang P, Chen T, Liu Y, Hou Z, Wu K, Cao Y, Zhang J, Wang Z, Zhao H. The critical role of ZP genes in female infertility characterized by empty follicle syndrome and oocyte degeneration. Fertil Steril 2020; 115:1259-1269. [PMID: 33272616 DOI: 10.1016/j.fertnstert.2020.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To identify the major causative gene(s) of genuine empty follicle syndrome (GEFS) characterized by oocyte degeneration. DESIGN Genetic and functional studies. SETTING University-based reproductive medicine center. PATIENT(S) Thirty-five unrelated women with GEFS and oocyte degeneration. INTERVENTION(S) Whole-exome sequencing (WES) and targeted Sanger sequencing. MAIN OUTCOME MEASURE(S) Variants predicted by software and the functional effects of variants assessed via Western blot and immunofluorescence in Chinese hamster ovary (CHO) cells. RESULT(S) We identified zona pellucida (ZP) gene variants in 18 individuals, which included 20 variants in the ZP1 gene, two variants in the ZP2 gene, and one previously reported recurrent variant in the ZP3 gene. The women carrying ZP variants constituted 51.43% of the GEFS cohort. The ZP1 variants were inherited in an autosomal recessive pattern; the ZP2 and ZP3 variants were inherited in an autosomal dominant pattern. All variants were predicted to be deleterious. Studies in CHO cells suggested that most ZP1 variants led to increased intracytoplasmic protein and some variants influenced the intracellular transportation of other ZP proteins. Variant p.R642Q of ZP2 caused the secretion of ZP2 protein with an increased molecular weight, suggesting altered protein modification. Variant p.I619N of ZP2 resulted in increased ZP2 protein in cell lysate and decreased ZP2 protein in culture medium. These results showed that ZP variants might block the intracellular transportation and secretion of ZP proteins and disrupt the zona pellucida. CONCLUSION(S) We identified novel variants of ZP genes in more than half the cohort with GEFS and oocyte degeneration. Variants of ZP genes caused protein intracellular sequestration and failure to assemble the ZP filaments, resulting in EFS and female infertility. Our findings not only reveal the critical roles of ZP genes but also pave the way for the efficient genetic diagnosis of females with GEFS and oocyte degeneration.
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Affiliation(s)
- Ping Yang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Shandong Key Laboratory of Reproductive Medicine, Jinan, People's Republic of China
| | - Tailai Chen
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yuqing Liu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Shandong Key Laboratory of Reproductive Medicine, Jinan, People's Republic of China
| | - Zhenzhen Hou
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Shandong Key Laboratory of Reproductive Medicine, Jinan, People's Republic of China
| | - Keliang Wu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Shandong Key Laboratory of Reproductive Medicine, Jinan, People's Republic of China
| | - Yongzhi Cao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Shandong Key Laboratory of Reproductive Medicine, Jinan, People's Republic of China
| | - Jiangtao Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Shandong Key Laboratory of Reproductive Medicine, Jinan, People's Republic of China
| | - Zhao Wang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Shandong Key Laboratory of Reproductive Medicine, Jinan, People's Republic of China
| | - Han Zhao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Shandong Key Laboratory of Reproductive Medicine, Jinan, People's Republic of China.
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Zhang Z, Wu L, Diao F, Chen B, Fu J, Mao X, Yan Z, Li B, Mu J, Zhou Z, Wang W, Zhao L, Dong J, Zeng Y, Du J, Kuang Y, Sun X, He L, Sang Q, Wang L. Novel mutations in LHCGR (luteinizing hormone/choriogonadotropin receptor): expanding the spectrum of mutations responsible for human empty follicle syndrome. J Assist Reprod Genet 2020; 37:2861-2868. [PMID: 32860205 DOI: 10.1007/s10815-020-01931-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/18/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To screen novel mutations in LHCGR responsible for empty follicle syndrome and explore the pathological mechanism of mutations. METHODS Four affected individuals diagnosed with infertility-associated anovulation or oligo-ovulation from three independent families were recruited. Sanger sequencing was used to identify the LHCGR mutations in affected individuals. Western blot was performed to evaluate the effects of mutations on LHCGR protein levels. Immunofluorescence was done to explore the effects of mutations on LHCGR subcellular localization. The ATP levels were measured to infer the functional effects of the mutations on LHCGR. RESULTS In the present study, three novel biallelic mutations in LHCGR were identified in four affected individuals from three independent families with empty follicle syndrome or oligo-ovulation. All biallelic mutations were inherited from the proband of their parents. The western blot showed that the identified mutations decreased LHCGR protein level and altered the glycosylation pattern. The immunofluorescence showed an ectopic subcellular localization of LHCGR in cultured HeLa cells. Besides, the mutations in LHCGR also reduced the cellular ATP consumption. CONCLUSION These findings confirm previous studies and expand the mutational spectrum of LHCGR, which will provide genetic diagnostic marker for patients with empty follicle syndrome.
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Affiliation(s)
- Zhihua Zhang
- Institute of Pediatrics, Children's Hospital of Fudan University and the Shanghai Key Laboratory of Medical Epigenetics, the International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology and Institutes of Biomedical Sciences, State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China
| | - Ling Wu
- Reproductive Medicine Center, Shanghai Ninth Hospital, Shanghai Jiao Tong University, Shanghai, 200011, China
| | - Feiyang Diao
- The State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Biaobang Chen
- NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, 200032, China
| | - Jing Fu
- Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - Xiaoyan Mao
- Reproductive Medicine Center, Shanghai Ninth Hospital, Shanghai Jiao Tong University, Shanghai, 200011, China
| | - Zheng Yan
- Reproductive Medicine Center, Shanghai Ninth Hospital, Shanghai Jiao Tong University, Shanghai, 200011, China
| | - Bin Li
- Reproductive Medicine Center, Shanghai Ninth Hospital, Shanghai Jiao Tong University, Shanghai, 200011, China
| | - Jian Mu
- Institute of Pediatrics, Children's Hospital of Fudan University and the Shanghai Key Laboratory of Medical Epigenetics, the International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology and Institutes of Biomedical Sciences, State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China
| | - Zhou Zhou
- Institute of Pediatrics, Children's Hospital of Fudan University and the Shanghai Key Laboratory of Medical Epigenetics, the International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology and Institutes of Biomedical Sciences, State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China
| | - Wenjing Wang
- Institute of Pediatrics, Children's Hospital of Fudan University and the Shanghai Key Laboratory of Medical Epigenetics, the International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology and Institutes of Biomedical Sciences, State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China
| | - Lin Zhao
- Institute of Pediatrics, Children's Hospital of Fudan University and the Shanghai Key Laboratory of Medical Epigenetics, the International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology and Institutes of Biomedical Sciences, State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China
| | - Jie Dong
- Institute of Pediatrics, Children's Hospital of Fudan University and the Shanghai Key Laboratory of Medical Epigenetics, the International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology and Institutes of Biomedical Sciences, State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China
| | - Yang Zeng
- Institute of Pediatrics, Children's Hospital of Fudan University and the Shanghai Key Laboratory of Medical Epigenetics, the International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology and Institutes of Biomedical Sciences, State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China
| | - Jing Du
- NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, 200032, China
| | - Yanping Kuang
- Reproductive Medicine Center, Shanghai Ninth Hospital, Shanghai Jiao Tong University, Shanghai, 200011, China
| | - Xiaoxi Sun
- Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - Lin He
- Bio-X Center, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Qing Sang
- Institute of Pediatrics, Children's Hospital of Fudan University and the Shanghai Key Laboratory of Medical Epigenetics, the International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology and Institutes of Biomedical Sciences, State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China. .,Zhuhai Fudan Innovation Institute, Zhuhai, 519000, Guangdong, China.
| | - Lei Wang
- Institute of Pediatrics, Children's Hospital of Fudan University and the Shanghai Key Laboratory of Medical Epigenetics, the International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology and Institutes of Biomedical Sciences, State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, 200032, China. .,Zhuhai Fudan Innovation Institute, Zhuhai, 519000, Guangdong, China. .,Shanghai Center for Women and Children's Health, Shanghai, 200062, China.
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Luo G, Zhu L, Liu Z, Yang X, Xi Q, Li Z, Duan J, Jin L, Zhang X. Novel mutations in ZP1 and ZP2 cause primary infertility due to empty follicle syndrome and abnormal zona pellucida. J Assist Reprod Genet 2020; 37:2853-2860. [PMID: 32829425 DOI: 10.1007/s10815-020-01926-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 08/13/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Mutations in the zona pellucida glycoprotein genes have been reported to be associated with empty follicle syndrome (EFS) and abnormal zona pellucida (ZP). In this study, we performed genetic analysis in the patients with female infertility due to abnormal zona pellucida and empty follicle syndrome to identify the disease-causing gene mutations in these patients. METHODS We characterized three patients from two independent families who had suffered from empty follicle syndrome or abnormal zona pellucida. Whole exome sequencing and Sanger sequencing were used to identify the mutations in the families. Western blot was used to check the expression of wild type and mutant disease genes. RESULTS We identified two novel mutations in these patients, including a novel compound heterozygous mutation (c.507delC, p. His170fs; c.239 G>A, p. Cys80Tyr and c.241 T>C, p. Tyr81His) in ZP1 gene and a compound mutation in ZP2 gene (c.860_861delTG, p.Val287fs and c.1924 C>T, p.Arg642Ter). Expression of the mutant ZP1 protein (p. Cys80Tyr and p. Tyr81His) is significantly decreased compared with the wild-type ZP1. Other three mutations produce truncated proteins. CONCLUSIONS Our findings expand the mutational spectrum of ZP1 and ZP2 genes associated with EFS and abnormal oocytes and provide new support for the genetic diagnosis of female infertility.
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Affiliation(s)
- Geng Luo
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology and Center for Human Genome Research, Huazhong University of Science and Technology, Wuhan, 430074, Hubei, China
| | - Lixia Zhu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhenxing Liu
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology and Center for Human Genome Research, Huazhong University of Science and Technology, Wuhan, 430074, Hubei, China
| | - Xue Yang
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology and Center for Human Genome Research, Huazhong University of Science and Technology, Wuhan, 430074, Hubei, China
| | - Qingsong Xi
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhou Li
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jinliang Duan
- Reproductive Medical Center, No.924 Hospital of Chinese People's Liberation Army, Guilin, Guangxi, China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Xianqin Zhang
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology and Center for Human Genome Research, Huazhong University of Science and Technology, Wuhan, 430074, Hubei, China.
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10
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Liu M, Shen Y, Zhang X, Wang X, Li D, Wang Y. Novel biallelic loss-of-function variants in ZP1 identified in an infertile female with empty follicle syndrome. J Assist Reprod Genet 2020; 37:2151-7. [PMID: 32556881 DOI: 10.1007/s10815-020-01855-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 06/07/2020] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Empty follicle syndrome (EFS) refers to the inability to obtain mature oocytes after appropriate ovarian stimulation during the process of in vitro fertilization (IVF). However, the specific cause and mechanism of action underlying EFS remain to be further explored. Herein we aimed to investigate the clinical and genetic characteristics of EFS. METHODS After data were collected in an infertile family, we performed whole-exome sequencing (WES) on the patient and confirmed the pathogenic mutations through Sanger sequencing. Western immunoblotting, immunofluorescence staining, and minigene assay were further used to investigate the negative effects of these mutations. RESULTS Absence of oocytes was observed over 2 cycles of IVF in the patient, and we evaluated the novel compound heterozygous mutations c.2T>A (p. M1K) and c.1112+1G>T of the zona pellucida glycoprotein 1 gene (ZP1, MIM# 195000) by WES. For the family under study, EFS was classified as an autosomal recessive inheritance pattern. The results of western blotting and immunofluorescence staining analyses confirmed that the missense mutation of c.2T>A [p. M1K] resulted in almost missing protein production. Additionally, using a minigene assay, we demonstrated the deleterious effect on the ZP1 gene of the splice site mutation c.1112+1G>T, which caused truncation of ZP1 protein. CONCLUSIONS The compound heterozygous mutations of ZP1 gene identified in this study by genetic and functional experiments constituted a novel genetic cause of EFS, and further study will expand its use in the clinical and molecular diagnoses of EFS.
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11
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Cao XL, Sun ZG. Borderline form of empty follicle syndrome treated with a novel dual trigger method combined with delayed oocyte retrieval: A case report. World J Clin Cases 2020; 8:825-830. [PMID: 32149067 PMCID: PMC7052558 DOI: 10.12998/wjcc.v8.i4.825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 01/10/2020] [Accepted: 01/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Borderline form of empty follicle syndrome is a condition in which only a few mature or immature oocytes are recovered after meticulous follicular aspiration, despite adequate ovarian response to stimulation. It is a rare phenomenon with an unclear cause. Currently, the condition still lacks effective treatment.
CASE SUMMARY A patient with secondary infertility who had undergone three cycles of assisted reproductive technique (ART) is described. With regard to good follicular response, two oocytes were obtained in the first two ART cycles, but no embryo was formed. In the third ART cycle, which is the subject of this study, ovulation was induced by dual trigger of a supernormal dose of human chorionic gonadotropin (HCG) combined with a delayed oocyte retrieval approach. The method involved administration of gonadotropin-releasing hormone agonist, recombinant HCG, and urinary HCG 39 h before ovum pick-up. Ten oocytes were recovered, two out of three mature eggs were fertilized after intracytoplasmic sperm injection, resulting in two embryos that were subsequently cryopreserved. The case report guidelines have been used herein to present the first case of this novel dual trigger method.
CONCLUSION This approach provides a new treatment option for patients with a similar condition in the future. This study can also inspire further investigation on the effects of various β-HCG serum levels 36 h after intramuscular HCG administration.
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Affiliation(s)
- Xian-Ling Cao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250011, Shandong Province, China
- Integrative Medicine Research Centre of Reproduction and Heredity, the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011, Shandong Province, China
| | - Zhen-Gao Sun
- Integrative Medicine Research Centre of Reproduction and Heredity, the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011, Shandong Province, China
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12
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Kaluarachchi A, Seneviratne HR, Batcha TM, Wijeratne S, Jayawardena GRMUGP. Recurrent empty follicle syndrome with different stimulation protocols - A case report. J Family Med Prim Care 2019; 8:2536-2537. [PMID: 31463291 PMCID: PMC6691437 DOI: 10.4103/jfmpc.jfmpc_418_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We report a case of recurrent empty follicle syndrome (EFS) where no oocytes were aspirated in two separate IVF cycles using two different protocols. In the second cycle, oocyte aspiration in one ovary was delayed for 24 hours after administering a second dose of human chorionic gonadotropin injection (hCG) and still no oocytes were recovered. In view of the presence of severe male factor infertility and failure to retrieve oocytes in 2 stimulated cycles, the couple was offered donor embryo transfer which resulted in a singleton pregnancy. A baby girl weighing 2800 g was delivered by an elective caesarean section at term. This case highlights that the change of protocol or repeat hCG administration is unlikely to change the outcome of genuine empty follicle syndrome.
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Affiliation(s)
- Athula Kaluarachchi
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Hajshafiha M, Behrouzi Lak T, Hajiloo N, Deldar Y, Ghorbani M, Haghollahi F. Evaluation of follicular fluid's Beta-Human chorionic gonadotropin in the follicles of patient undergoing Intracytoplasmic sperm injection: A cross-sectional study. Int J Reprod Biomed 2019; 16. [PMID: 31417985 PMCID: PMC6600285 DOI: 10.18502/ijrm.v16i12.3686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 02/13/2018] [Accepted: 08/12/2018] [Indexed: 11/24/2022] Open
Abstract
Background The failure to retrieve oocytes from mature ovarian follicles is referred to as empty follicle syndrome. There is no exact explanation to this problem and it cannot be predicted using ultrasound or serum hormonal levels. The underlying mechanism of Empty follicle syndrome remains obscure. Objective In this study, the authors have investigated the relationship between the Beta-Human chorionic gonadotropin ( β HCG) levels in the follicular fluid with or without the oocyte in the follicles of patients undergoing Intracytoplasmic Sperm Injection. Materials and Methods Seventy-three infertile couples underwent standard long protocol induction ovulation for Intracytoplasmic sperm injection. On the day of oocyte retrieval, each patient had two samples; follicular fluid including 2-3 follicles with oocyte and follicular fluid including of 2-3 follicles without oocyte were collected in separate tubes. These follicles had similar shape and size. The Samples were transferred to a laboratory for measuring the β HCG level, after which the β HCG levels were compared to the follicles with and without the oocyte in each patient. Results In this study, the β HCG level of follicular fluid in the follicles containing oocyte was 18.20 (8.35-42.92) IU/L and in the follicles without the oocyte was 13.50 (5.45-25.81) IU/L. Levels of β HCG in the follicular fluids containing the oocyte were higher than without oocytes, This difference was not statistically significant (p = 0.16). Conclusion It seems that the follicular fluid β HCG isn't caused by empty follicle syndrome, and that dysfunctional folliculogenesis may be the cause of this syndrome.
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Affiliation(s)
- Masoumeh Hajshafiha
- Department of Obstetrics and Gynecology, Urmia Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Tahere Behrouzi Lak
- Department of Obstetrics and Gynecology, Urmia Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Nasrin Hajiloo
- Motahary Hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Yaghoub Deldar
- Clinical Biochemistry, Urmia University of Medical Sciences, Urmia, Iran
| | - Mina Ghorbani
- Motahary Hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Fedyeh Haghollahi
- Vali-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
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14
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Yuan P, Li R, Li D, Zheng L, Ou S, Zhao H, Zhang Q, Wang W. Novel mutation in the ZP1 gene and clinical implications. J Assist Reprod Genet 2019; 36:741-747. [PMID: 30778819 DOI: 10.1007/s10815-019-01404-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 01/09/2019] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Empty follicle syndrome (EFS) is a complex reproductive disorder characterized by the repeated failure to aspirate oocytes from mature ovarian follicles during in vitro fertilization (IVF). In addition to some cases caused by iatrogenic problems and known genetic factors, there are still many unexplained aspects of EFS. Here, we aimed to assess the clinical and genetic characteristics of two EFS patients. METHODS We have characterized two primary infertility patients with EFS in a nonconsanguineous family from China. Both the patients presented similar clinical phenotypes, that is a few granulosa cells but no oocytes could be retrieved during repeated cycles with normal follicular development, E2 levels, and bioavailable hCG plasma levels. Abnormal oocytes were obtained once or twice between multiple IVF cycles. We performed Sanger sequencing of the LHCGR and ZP1~ZP4 genes in the patients, and further bioinformatics analysis was performed to identify pathogenic elements in the genes. RESULTS A novel mutation, c.181C>T (p.Arg61Cys), and a known mutation, c.1169_1176delTTTTCCCA (p.Ile390Thrfs*16), in the ZP1 gene were both identified in patient 2, but no mutations were identified in patient 1. The novel mutation inherited from her mother was absent in the control cohort and the ExAc database. The arginine residue is conserved at this position, and its replacement by cysteine was predicted to be deleterious. In another allele, a paternal frameshift mutation was predicted to introduce premature stop codons, resulting in the deletion of 234 amino acids from the C-terminus of the ZP1 protein. CONCLUSIONS Our findings presented compound heterozygous mutations in ZP1 associated with EFS and abnormal oocytes and provided further new evidence for the genetic basis of EFS and support for the genetic diagnosis of infertile individuals.
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Affiliation(s)
- Ping Yuan
- IVF Center, Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, 510120, Guangdong, China
| | - Ruiqi Li
- IVF Center, Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, 510120, Guangdong, China
| | - Di Li
- IVF Center, Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, 510120, Guangdong, China
| | - Lingyan Zheng
- IVF Center, Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, 510120, Guangdong, China
| | - Songbang Ou
- IVF Center, Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, 510120, Guangdong, China
| | - Haijing Zhao
- IVF Center, Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, 510120, Guangdong, China
| | - Qingxue Zhang
- IVF Center, Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, 510120, Guangdong, China
| | - Wenjun Wang
- IVF Center, Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, 510120, Guangdong, China.
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15
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Hossein YektaKooshali M, Hamidi M, Mohammad Taghi Razavi Tousi S, Nikokar I. Prevalence of group B streptococcus colonization in Iranian pregnant women: A systematic review and meta-analysis. Int J Reprod Biomed 2019; 16. [PMID: 31417981 PMCID: PMC6600281 DOI: 10.18502/ijrm.v16i12.3679] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 01/13/2018] [Accepted: 09/12/2018] [Indexed: 11/24/2022] Open
Abstract
Background Group B Streptococcus (GBS) is an important pathogen in newborns and pregnant women. Objective The present study was carried out to estimate the prevalence of GBS colonization in pregnant women in Iran. Materials and Methods This systematic review and meta-analysis was based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline using the national databases including Society for Information Display, Magiran, Irandoc, Iran Medex, and international databases including MEDLINE, Web of Science, Scopus, PubMed, Science-Direct, Cochrane, Embase, Elton Bryson Stephens Company, Centre for Evidence-Based Medicine, Cumulative Index to Nursing and Allied Health Literature, and Google Scholar, published by 01/30/2017. The I2 index was used to measure heterogeneity between the studies. Results In a total of 667 documents, 30 (4.49%) were selected. In this study, the prevalence of GBS colonization in 10090 Iranian pregnant women was calculated as 13.65% [confidence interval (CI): 95%: 10.56–17.45]. Based on geographic region, 24.63% [CI: 95%: 11.52–45.06] in the West and 8.75% [CI: 95%: 6.43–11.8] in the East were the highest and lowest areas in Iran, respectively, and were statistically significant (p = 0.001). Also, with regards to swapping sampling area, Vaginal with 11.96%, Vaginal and Rectal with 13.62%, and Anal and Vaginal with 25.63% were the least to the greatest, respectively, and were statistically significant (p = 0.001). Conclusion Therefore, based on the recommendation of Centers for Disease Control and Prevention as reported by the Ministry of Health and Medical education, early diagnosis, and screening of high-risk women should be done at 35–37 weeks of pregnancy.
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Affiliation(s)
- Mohammad Hossein YektaKooshali
- Student Research Committee, School of Nursing-Midwifery and Paramedicine, Guilan University of Medical Sciences, Rasht, Iran.,Medical Biotechnology Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Masoud Hamidi
- Medical Biotechnology Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Iraj Nikokar
- Medical Biotechnology Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Abstract
Accumulating evidence showed that the luteinizing hormone/chorionic gonadotropin receptor (LHCGR) is an essential regulator of sexual development and reproduction from zebrafish to human. Activating and inactivating mutations of LHCGR gene have been identified from patients of different phenotypes. Familial male-limited precocious puberty, Leydig cell hypoplasia, and empty follicle syndrome are caused by LHCGR mutations. More than 50 mutations have been reported from subjects of different ethnic backgrounds. Functional analyses of the mutant LHCGR revealed multiple defects, including cell surface expression, ligand binding, and signaling. The difference of the two native ligands and signaling pathway activated by LHCGR are illustrated. Potential therapeutic implications from the analyses of the naturally occurring LHCGR mutations, such as pharmacological chaperones, are highlighted.
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Affiliation(s)
- Jie Qiao
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
| | - Bing Han
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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Deepika K, Sindhuma D, Kiran B, Ravishankar N, Gautham P, Kamini R. Empty Follicle Syndrome Following GnRHa Trigger in PCOS Patients Undergoing IVF Cycles. J Reprod Infertil 2018; 19:16-25. [PMID: 29850443 PMCID: PMC5960047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND The objective of this study was to analyze the incidence and the underlying mechanisms of empty follicle syndrome (EFS) occurring in gonadotropin releasing hormone agonist (GnRHa) triggered in in vitro fertilization (IVF) cycles with GnRH antagonist protocol in women with polycystic ovary syndrome (PCOS) of Indian origin. The study also intended to evaluate the cycle outcome following a rescue trigger. METHODS Retrospective cohort analysis of data was extracted from the hospital database of 271 PCOS patients who underwent IVF in antagonist protocol triggered with GnRHa from August 2014 to December 2016. All cases with failure to obtain oocytes following retrieval were analyzed. Continuous variables were expressed as mean±SD using t-test and Chi-squared test for categorical variables. A p<0.05 was considered statistically significant. RESULTS Incidence of EFS following GnRHa trigger was found to be 3.3%. False empty follicle syndrome (FEFS) accounted for majority of the cases (8/9=88.8%). Of the nine EFS, six cases were salvaged with a rescue trigger, resulted in transfer of reasonably good quality embryos in a frozen-thawed embryo replacement cycle achieving clinical pregnancy in three cases (3/6=50%). CONCLUSION Our experience with EFS cases following GnRHa, albeit small, given the rarity of its occurrence, suggests that majority of EFS are of false forms and can be effectively salvaged which results in reasonably favorable outcome.
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Affiliation(s)
- Krishna Deepika
- Corresponding Author: Krishna Deepika, Senior Consultant in Reproductive Medicine, Milann, The Fertility Center, A Unit of BACC Health care pvt Ltd, #7, East Park Road, Kumara Park East, Bangalore-560001, Karnataka, India, E-mail:
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Tanaka R, Murase M, Aizawa Y, Segino M, Ishidera Y, Kitagawa M, Katayama K, Takashima K, Yumura Y, Yoshida H, Sakakibara H, Hirahara F. A case of empty follicle syndrome who conceived after aspiration of an endometrial cyst. Reprod Med Biol 2013; 12:111-115. [PMID: 29699138 DOI: 10.1007/s12522-013-0146-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 03/25/2013] [Indexed: 11/27/2022] Open
Abstract
Empty follicle syndrome (EFS) has been defined as a condition where no oocytes can be retrieved for in vitro fertilization (IVF) even though ultrasound findings and estradiol (E2) levels suggest the presence of potential follicles. The EFS is a rare condition with an incidence of 0.5-7 % of women undergoing IVF treatments. Although there are many hypotheses as to the cause of EFS, including advanced ovarian age, drug-related problems, and dysfunctional folliculogenesis, its cause remains unknown. A 37-year-old woman with endometriosis and a 5-year history of primary infertility underwent IVF treatment for 4 cycles. No oocytes were retrieved in 2 cycles and no fertilized eggs were obtained in the other 2 cycles. We assumed that endometriosis adversely affected folliculogenesis and fertilization. Aspiration of an endometrial cyst in the right ovary and subsequent administration of oral contraceptives resulted in successful folliculogenesis and fertilization. Thereafter, she conceived and delivered a 2,662 g female infant at 38 weeks of gestation. Here, we report a case of EFS who conceived in the 5th IVF cycle after aspiration of an endometrial cyst. We assumed that endometriosis might have been involved in the dysfunction of folliculogenesis and EFS.
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Affiliation(s)
- Rieko Tanaka
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Mariko Murase
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Yoshino Aizawa
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Miwa Segino
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Yumi Ishidera
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Masakazu Kitagawa
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Kayo Katayama
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Kunitomo Takashima
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Yasushi Yumura
- Department of Urology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Hiroshi Yoshida
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Hideya Sakakibara
- Department of Obstetrics and Gynecology Yokohama City University 3-9 Fukuura, Kanazawa Ward 236-0004 Yokohama Kanagawa Japan
| | - Fumiki Hirahara
- Department of Obstetrics and Gynecology Yokohama City University 3-9 Fukuura, Kanazawa Ward 236-0004 Yokohama Kanagawa Japan
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